Candance Kimbrough-Green, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

45268 Issued in GA

Practice address

4800 Olde Towne Pkwy Ste 250
Marietta, GA 30068-4428

Phone

(770) 971-3376

NPI assigned

Dec 22, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of Michigan Medical School, 1988

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ckimbrough-green@directaddress.net
• Direct secure messaging: cgreen@dessna.emadirect.md

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Dermatology and Surgery Specialists of North Atlanta PC

  • Dermatology Physician
  • Marietta, GA
  • NPI 1447851357
  Medicare reassignment NPD
• Dermatology Consultants, P.C.

  • Dermatology Physician
  • Atlanta, GA
  • NPI 1851421531
  Medicare reassignment NPD
• Dermatology Associates of Glastonbury LLC

  • Dermatology Physician
  • Glastonbury, CT
  • NPI 1730175845
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1135209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588204800000",
    "number": "1366428146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684428",
            "telephone_number": "770-971-3376",
            "fax_number": "770-578-8567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 OLDE TOWNE PKWY STE 250",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684428",
            "telephone_number": "770-971-3376"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2045 Peachtree Rd NE Ste 200",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30309",
            "country_code": "US",
            "telephone_number": "404-351-7546 x267",
            "fax_number": "404-351-2993",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KIMBROUGH-GREEN",
        "first_name": "CANDANCE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-22",
        "last_updated": "2020-04-30",
        "certification_date": "2020-04-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "GA",
            "license": "45268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kim
• Stephen Kim, M.D.
• Kay Ann Kimball, CNP
• Johanna Kimberl, PA-C
• Kimberly Wallace LPC LLC
• Kimchang & Company, LLC
• Kirk Andrew Kimmerling, D.D.S.
• Patricia White Kimmerling, D.D.S.
• Felicia Cohila Kincaid, RN
• William R. Kincer, D.M.D.

• Dermatology Physician in Marietta, GA
• Providers in Marietta, GA by specialty
• Dermatology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.